Patient falls are a major problem in healthcare facilities. Patients can be confused from post-operative delirium, medical illness, dementia, or brain injury. These conditions can lead to poor balance, decreased deficit awareness, and impulsivity. Patients will often try to get out of bed without requesting assistance from the medical staff. Even when a patient requests assistance from the medical staff, their delayed response time has been identified as a major cause of patients getting out of bed unassisted.
One way to prevent these injuries is to restrain the patient. Currently, there are two general classes of restraints available. The first class secures the person, but the person can essentially release himself or herself at will. Example mechanisms in this class include Velcro straps, buckles, or seat belts. The second class of restraints is lockable which prevents the person from releasing himself or herself. Generally, in practice, all lockable belts use a universal key. Universal keys are located throughout the facility so that they are readily accessible in an emergency situation. If the patient in the locked belt wants to get up, the patient must either notify the staff directly or request assistance by pressing a nearby call bell. If the call bell is pressed, the patient is forced to remain in place until a staff member responds. This poses a potential safety hazard to the patient in emergency situations. It can also unreasonably limit their autonomy if the staff fails to attend to them within a reasonable time.
In addition to the safety concerns of the lockable restraints, their use is strictly regulated by state law and hospital accreditation guidelines. Many state laws only allow for the use of restraints if they are absolutely necessary to protect the patient or others from injury and less restrictive alternatives prove inadequate. This can mean that a patient must get out of bed and fall before the patient is placed in lockable restraints.
One method that is employed to further ensure patient safety is to install sensors that will notify medical staff of patient movement. For example, sensors can be installed on a patient bed to notify the medical staff when a patient gets up. These sensors serve a limited role in preventing falls because the staff is not alerted until after the patient has gotten up.